Considering and Starting a Career in Family Therapy

By Dr. Amanda Craig, LMFT

The field of marriage and family therapy is a fascinating way to work with the art of behavior change and relational dynamics. Meeting new people and hearing their life stories: it’s humbling to be trusted with such private intimate thoughts and feelings. 

The path to become a seasoned therapist includes several milestones of accomplishment. The first step is often a two-year graduate program to learn theory, treatment and intervention practices, ethics, cultural competency, and special topic classes geared towards therapist’s individual interests.  During coursework there is often a first internship, followed by a second year practicum and often a Master’s thesis. 
 
Following the formal education process therapists gain supervised hours for usually two years.  During this period therapists see clients under close supervision by an approved supervisor.  Finally, after the completion of the state’s required supervised hours and a state test, full licensure is obtained. 
 
Each step is crucial to the development of a well-rounded therapist.   Interns and practicum students are still primarily focused on the therapeutic orientations learned in their program and are starting to acquire some of their first hands-on clinical experience. This is where all good therapists start their careers.
 
The creativity and eagerness that manifests during this period of one's career building can be truly inspiring.  And the frustration and impatience of having to collect hours only teaches pacing and humility in the face of obstacles and transition.  Here, budding therapists feel many of the feelings they will help their clients wrestle with.   
 
Once graduation is completed, therapists are responsible for meeting the requirements of their licensing board, as well as State and Federal statutes. These obligations define many things including documentation procedures, ethical guidelines, insurance and tax responsibilities, and full licensing requirements. While agency work does not usually pay as well as private practice (you will quickly find private practice has its own set of headaches), it offers invaluable experience on regulatory, licensing, ethical, and business practices of the industry.  
 
Whether you work for a non-profit, for profit, small private practice, treatment center, government, school system, hospital, or church, the experience will yield substantial amounts of information that will empower you to build your personal mental health career.
 
For example,  therapists will:

• Become proficient with client assessment and diagnosis
• Participate in group case consultation
• Fulfill paperwork requirements for State and Federal statutes
• Understand insurance reimbursement procedures
• Practice the patient intake process
• Develop personal referral sources and client lists
• Attend training and continuing education programs
• Be privy to agency mission statement and short and long-term agency goal setting
• Observe how the financial and budget plans are impacted by service delivery practices.
• Define a business model for an effective private practice that fits YOU!

 
Can a therapist go into private practice immediately once licensed? Sure, but you will miss out on the valuable experience that is definitely worth investing a year or two of your early post-license career.
 
While working for an agency, you can accumulate supervised hours (often for free), focus on early post-graduate clinician development, all the while you plan and begin building a private practice plan that is well-thought-out and primed for success.
 
What if I am ready to start a private practice?
 
Here are some practical tips to help you build confidence in opening an individual private practice.

• Have a clinical supervisor AND a private practice mentor.  Hopefully they can be one and the same (Check out this blog7 Crucial Questions To Ask BEFORE You Hire a Clinical Supervisor for additional information.)
  

•  Decide what type of business you want: PLLC, PC, or sole proprietor.  All have pros and cons depending on your long-term goals.  This will also put you in touch with a lawyer and a tax preparer which will be helpful with other aspects of your business growth and development.

• Have a business plan in writing.  Having a plan written out with a timeline can help you organize your direction and ground you when you are feeling overwhelmed.  Make goals realistic and obtainable.  Break large goals down to smaller, easier to achieve, goals.   The plan should include short and long-term goals, time line, important resources, a growth pattern, etc. Get a complimentary copy of a MFT Business Plan Template when you sign up for our e-mail list.

• Find your niche.  If you know what population you want to work with you will have a better idea about your referral network.  For instance, if you want to work with women—get connected with OBGYNs; if you want to work with children —get connected to local schools near your practice; or if you want to do bereavement and end-of-life work—get connected with hospices, cancer centers and insurance agents.  Knowing your niche will help you decide how to market your business.

• Know you are going to feel the uneasiness of taking a risk.  You cannot grow and learn without taking a risk.  Have strategies for when you feel fear and anxiety so it does not block your growth.

 
More questions? Check out the NYC state licensing board's website: http://www.op.nysed.gov/prof/mhp/mftbroch.htm
 
Want to get connected?  Check out NYAMFT where you can meet with other MFTs.
http://www.nyamft.org/ohana/website/index.cfm?p=95575656632